ABSTRACT
Introducción: El efecto de la donación a repetición de plaquetas por aféresis sobre el eritrograma se desconoce para población colombiana. Objetivo: Evaluar los cambios en la línea eritroide de donantes habituales de plaquetoaféresis de dos bancos de sangre de Medellín. Métodos: Estudio longitudinal con 100 donantes repetitivos de plaquetoaféresis con 3 donaciones o más. La fuente de información fueron las bases de datos de los bancos de sangre participantes. Los datos demográficos, tiempo entre donaciones y parámetros eritocitarios fueron consignados en una base de datos de excel y analizados empleando el software SPSS versión 27.0. Se realizó descripción de variables mediante medidas de resumen y se emplearon las siguientes pruebas estadísticas: T de Student, U de Mann Whitney, correlaciones, T pareada y Wilcoxon, considerándose un nivel de significación estadística de <0,05. Resultados: El 58% de los donantes fueron mujeres, el 75% tenían 30 años o más y 70% residían en el área metropolitana. No se observaron diferencias estadísticamente significativas para la hemoglobina según sexo y grupo etario, el VCM aumentó en la segunda, tercera y cuarta donación respecto a la primera, el HCM disminuyó en la cuarta donación respecto a la primera y el CHCM disminuyó continuamente entre donaciones. Conclusiones: Se observaron cambios en los parámetros eritrocitarios en los donantes recurrentes de plaquetas correspondientes a mecanismos medulares compensatorios normales sin afectación clínica de los donantes. Se sugiere realizar estudios complementarios para evaluar otras variables relacionadas con la eritropoyesis y los efectos de la circulación extracorpórea durante la plaquetoaféresis.
Introduction: The effect of repeated platelet donation by apheresis on the erythrogram is unknown for the Colombian population. Objective: evaluate the changes in the erythroid line in regular plateletpheresis donors from two blood banks in Medellin. Methods: Longitudinal study with 100 repetitive plateletpheresis donors with 3 donations or more. The source of information was the databases of the participating blood banks. Demographic data, time between donations and erythrocyte parameters were recorded in an excel database and analyzed using SPSS version 27.0 software. Variables were described using summary measures and the following statistical tests were used: Student's t-test, Mann-Whitney U, correlations, paired t-test, and Wilcoxon, considering a level of statistical significance of <0.05. Results: 58% of the donors were women, 75% were 30 years old or older, and 70% resided in the metropolitan area. No statistically significant differences were observed for hemoglobin according to sex and age group, the MCV increased in the second, third and fourth donations compared to the first, the HCM decreased in the fourth donation compared to the first, and the CHCM decreased continuously between donations. Conclusions: Changes in erythrocyte parameters were observed in recurrent platelet donors corresponding to normal compensatory medullary mechanisms without clinical involvement of the donors. Complementary studies are suggested to evaluate other variables related to erythropoiesis and the effects of extracorporeal circulation during plateletpheresis.
Subject(s)
HumansABSTRACT
OBJECTIVE: Currently, there are discrepancies in the reports on the extent of the reduction in platelet count after platelet donation by apheresis, and its impact on mean platelet volume (MPV). This study was conducted to meta-analyze the effect of plateletpheresis on platelet count and on mean platelet volume, based on studies published between 1980 and 2018. METHODS: Medline-Pubmed, Scielo, ScienceDirect, and Scopus databases were searched from inception to December 31 2019. The PRISMA guidelines, reproducibility, and evaluation of the methodological quality were guaranteed. Heterogeneity was evaluated with DerSimonian-Laird's, publication bias with a Begg's test. Sensitivity analysis and cumulative meta-analysis were also conducted, as well as a forest plot. RESULTS: Twenty-five studies with 3769 donors were systematized to analyze platelet count, and seven studies with 1176 donors to observe MPV. Most studies were published in India and the United States. There was a postprocedure reduction in both variables. The reduction in platelet count was 14.3 × 103 /µL (95% CI 11.4 to 17.1 × 103 /µL). The reduction in MPV was 1.43 fL (95% CI 0.3 to 2.5 fL). The analysis of subgroups showed that, in the case of platelet count, the reduction is not statistically significant two weeks after donation. CONCLUSION: Platelet donation by apheresis reduces platelet count and MPV in donors, which is detrimental to the purposes of the procedure; although the decrease is not clinically significant for the donor or the recipient. This demonstrates the need for subsequent studies to evaluate variables, such as donation frequency and donation intervals, should be considered to evaluate if the reported decrease is easily compensated, without adverse consequences for donors, or if modifications in donor selection criteria are required.